People diagnosed with attention-deficit/hyperactivity disorder face a roughly 71% higher risk of early death than those without the condition, according to a new review published in JAMA Network Open.
The review also found that taking prescribed ADHD medication was linked to a lower overall risk of death among people with the condition.
Researchers examined data from 19 observational studies covering nearly 16 million people across three continents, looking at both unnatural causes of death, such as injuries and suicide, and natural causes, including cardiovascular disease and diabetes. Elevated mortality showed up across all of these categories for people with ADHD.
“We found that people with ADHD face an increased risk not only of death by suicide and injury, but also of deaths by natural causes, adding to evidence that health inequalities faced by people with ADHD are broad and wide-ranging,” said senior author Joshua Stott, professor of aging and clinical psychology at University College London.
The risk of death by suicide was 89% higher among people with ADHD, while the risk of dying from intentional or unintentional injuries, such as motor vehicle accidents, was 55% higher. Death from natural causes was 27% more likely.
Researchers said the elevated risk from natural causes is often connected to long-term health behaviors such as smoking and substance use, as well as difficulties with executive function that can make it harder to manage chronic illness, keep medical appointments and stick to treatment plans.
In one analysis, researchers looked at whether medication changed outcomes. Among people with ADHD, those taking prescribed medication for the condition had a 25% lower risk of death from any cause compared with those who were not medicated, suggesting effective treatment may reduce some of the behavioral and health risks tied to ADHD.
“ADHD is not by definition a life-limiting condition, as the right support and treatment can help people live long and healthy lives,” Stott said. “Our findings underscore the importance of ensuring that everyone who may have ADHD has access to accurate diagnosis and treatment.”
Limitations
The researchers cautioned that all of the included studies were observational, meaning the findings show associations rather than proof of cause and effect. The data on medication came from just three of the 19 studies, making those results preliminary and based on a comparatively small group of people.
Results also varied widely across the individual studies because of differences in diagnostic criteria, access to health care and methods used to track outcomes. Factors such as socioeconomic status and other mental health conditions were not controlled for across the data sets.
“Our findings provide early evidence to suggest that medication may play an important role in supporting the health of people with ADHD, but this is based on a small number of studies and further research is needed to clarify this link,” said first author Lucy Corrigan, a research assistant in the University of Liverpool’s Department of Psychology. “Medication is just part of the story; many people with ADHD benefit from comprehensive, long-term treatment and support.”
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